Objectives: Sexuality on the whole and erectile response particularly are not alien to psychosocial and couple features. We review al psychological and couple features that interfere on erection and also point out the interventional directions of couple therapy that give the best results in the treatment of erectile dysfunction.
Methods: We performed a bibliographic review about the psychological and social features under the current way of life in relation to erectile response physiology, in addition to review different models of couple therapy.
Results/conclusions: The separation of the couple reproduction-pleasure achieved in the 50's enabled a progressive claim from women of their need to be satisfied, representing one of the reasons that led to the phenomenon of "performance anxiety" that, altogether with some toxic habits (Tobacco consumption, alcohol, drugs, sedentary life, etc) help the appearance of erectile dysfunction. When psychological factors are an important part of the problem, couple sexual therapy in combination with phosphodiesterase 5 inhibitors is the therapy of choice.